Stable pharmaceutical composition of vasopressin

ABSTRACT

The present invention relates to a stable pharmaceutical composition comprising vasopressin or pharmaceutically acceptable salts thereof. The present invention further provides a method of increasing blood pressure in adults with vasodilatory shock by administering said pharmaceutical composition of vasopressin or pharmaceutically acceptable salts thereof.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a Continuation of application Ser. No. 16/981,892,filed Sep. 17, 2020, which is U.S. national stage application under 35U.S.C. § 371 of PCT Application No. PCT/IB2019/052117, filed Mar. 15,2019, which claims priority to Indian Patent Application No.201811010144, filed Mar. 20, 2018, the entireties of which areincorporated herein by reference.

FIELD OF THE INVENTION

The present invention relates to a stable pharmaceutical compositioncomprising vasopressin or pharmaceutically acceptable salts thereof.

BACKGROUND OF THE INVENTION

Vasopressin is a polypeptide hormone. Vasopressin contains nine aminoacids, with a disulfide bridge between cysteine residues. Chemicallyvasopressin iscyclo(1-6)-L-cysteinyl-L-tyrosyl-L-phenylalanyl-L-glutaminyl-L-asparaginyl-L-cysteinyl-L-prolyl-L-arginyl-L-glycinamide.

Vasopressin is indicated to increase blood pressure in adults withvasodilatory shock (e.g. postcardiotomy or sepsis) who remainhypotensive despite fluids and catecholamines. It is available under thetrade name of Vasostrict® Solution; Intravenous (IV) for Infusion withpH of 3.8 and supplied as 20 units/ml and 200 units/10 ml.

U.S. Pat. No. 9,375,478 and its family discloses a pharmaceuticalcomposition comprising vasopressin and a buffer having acidic pH. Italso discloses that greatest level of stability of vasopressinformulation was observed at pH 3.5. However, the formulation claimed inU.S. '478 patent is having pH of 3.8.

US Pub. No. 2017/0354708 A1 discloses pharmaceutical compositioncomprising vasopressin, or a pharmaceutically-acceptable salt thereof;and a polymeric pharmaceutically-acceptable excipient. It also disclosesthat vasopressin assay in the vasopressin formulations with citratebuffer is lower than in the vasopressin formulations with acetatebuffer. It also discloses that vasopressin formulations are stable at pHvalues in the range of 3.5 to 4.5. The results of the experimentssuggested that the stability of a vasopressin formulation was highestbetween pH 3.6 and pH 3.8.

U.S. Pat. No. 9,744,239 discloses a method of increasing blood pressurewith a unit dosage form of vasopressin, wherein the unit dosage form isdiluted in 0.9% saline or 5% dextrose in water to provide aconcentration from about 0.1 units/mL to about 1 unit/mL of vasopressinand administering the diluted unit dosage form to the human byintravenous administration.

US Pub. No. 2018/0015168 A1 discloses therapeutic formulation comprisinga protein active ingredient and a stabilizing excipient such aspolypropylene glycol homopolymer.

U.S. Pat. No. 6,949,509 discloses stable composition of vasopressin freeof preservatives wherein the composition has a pH between 3.5 and 6.

U.S. Pat. No. 5,482,931 discloses aqueous composition for administrationof small and medium-size peptides comprising buffer, a quaternary aminepreservative or disinfectant and an osmotic pressure-controlling agent.It also discloses pH of the composition between about 4 and 6.

US Pub. No. 2011/0237508 discloses formulation comprising vasopressin oran analogue thereof, a buffer and at least one non-toxic source ofdivalent metal ions in a concentration of at least 2 mM. It furtherdiscloses that such formulation is having a pH between 3 and 6,preferably between 3 and 5, more preferably between 3.8 and 4.8.

Aqueous formulations of therapeutic peptides are susceptible todegradation through a number of different mechanisms and as a result ofseveral types of stress conditions like freeze/thaw cycles, agitation,long term storage, pumping, filtration, or unrefrigerated storage.

Peptides can undergo deamidation during which an amide group is removedfrom an amino acid, and can be associated with protein degradation,apoptosis, and other regulatory functions within the cell. Thesusceptibility to deamidation can depend on primary sequence of theprotein, three-dimensional structure of the protein, and solutionproperties including, for example, pH, temperature, ionic strength, andbuffer ions. Deamidation can be catalyzed by acidic conditions.

In view of the above, it is therefore desirable to provide a stablepharmaceutical composition of therapeutic peptides to make thetherapeutic peptides more resistant to demidation and the stressconditions encountered during their distribution and storage. Applicanthas developed a composition of vasopressin which is having pH less thanor equal to 3.6 and is still stable with total impurities less than 5%upon storage at 2 to 8° C.

SUMMARY OF THE INVENTION

The present invention relates to a stable aqueous composition foradministration of small and medium-size peptides, particularlyvasopressin, which can maintain stability during its storage.

According to one aspect, the present invention provides a stablepharmaceutical composition comprising vasopressin or a pharmaceuticallyacceptable salt thereof and one or more pharmaceutically acceptableexcipients.

According to one embodiment, the pharmaceutical composition is in theform of aqueous solution or a lyophilized powder, which can be dilutedor reconstituted just prior to use.

According to another embodiment, the pharmaceutical composition is inthe form of ready to use composition.

According to another embodiment, the present invention provides a stablepharmaceutical composition comprising vasopressin or a pharmaceuticallyacceptable salt thereof and one or more pharmaceutically acceptableexcipients, wherein the one or more pharmaceutically acceptableexcipients are selected from the group comprising buffering agents,tonicity agents, pH adjusting agents, preservatives, vehicles, bulkingagents and lyoprotectants and/or combinations thereof.

According to another embodiment, the present invention provides a stablepharmaceutical composition comprising vasopressin or a pharmaceuticallyacceptable salt thereof and one or more pharmaceutically acceptableexcipients, wherein the composition has pH in the range of 2.4 to 3.6,preferably in the range of 2.8 to 3.2.

According to another embodiment, the present invention provides a stablepharmaceutical composition comprising vasopressin or a pharmaceuticallyacceptable salt thereof and one or more pharmaceutically acceptableexcipients, wherein the composition has less than 5% total impuritiesupon storage at 2 to 8° C. According to another embodiment, the presentinvention provides a stable pharmaceutical composition comprisingvasopressin or a pharmaceutically acceptable salt thereof andpharmaceutically acceptable excipients which is useful for increasingblood pressure in adults with vasodilatory shock.

DESCRIPTION OF THE INVENTION

The present invention relates to a stable aqueous composition foradministration of small and medium-size peptides, particularlyvasopressin, which can maintain stability during its storage.

Applicant has developed a stable pharmaceutical composition ofvasopressin which can encounter stress conditions like freeze/thawcycles, agitation, long term storage, pumping, filtration, orunrefrigerated storage. Applicant has developed a stable composition ofvasopressin having lower pH compared to prior art compositions havinghigher pH range.

While working on the present invention inventors have developed a stablepharmaceutical composition of vasopressin with glycine buffer. Theformulation showed maximum stability in the pH range of 2.4 to 3.6.

The pharmaceutical composition as per the present invention comprisesvasopressin or a pharmaceutically-acceptable salt thereof andpharmaceutically acceptable excipients, wherein the pharmaceuticalcomposition comprises from about 0.01 mg/mL to about 0.07 mg/mL ofvasopressin or pharmaceutically acceptable salts thereof.

The pharmaceutical composition is suitable for parenteral administrationto a patient. The pharmaceutical compositions can be in a form suitablefor parenteral injection such as a sterile suspension, solution, oremulsion in oily or aqueous vehicles.

The pharmaceutical composition as per the present invention may befilled into single dose vial or multi dose vial. The pharmaceuticalcomposition is free from preservatives when filled into a multi-dosevial/container.

The pharmaceutical composition as per the present invention comprisestherapeutically effective amount of vasopressin or pharmaceuticallyacceptable salts thereof and one or more pharmaceutically acceptableexcipients, wherein the one or more pharmaceutically acceptableexcipients are selected from the group comprising buffering agents,tonicity agents, pH adjusting agents, preservatives, vehicles, bulkingagents and lyoprotectants and/or combinations thereof.

Suitable buffering agent may include one or more of buffers such as, forexample, citrate, phosphate, tris HCl, acetic acid, sodium acetate,amino acids such as glycine, aspartate/aspartic acid, histidine,cysteine, tyrosine, phenylalanine, proline, arginine, threonine, serine,valine, isoleucine, lysine and glutamine. More preferably, the presentinvention comprises glycine as a buffer in a concentration of between0.006 mM to 0.16 mM.

In an embodiment of the present invention, there is provided apharmaceutical composition comprising vasopressin or apharmaceutically-acceptable salt thereof and a buffer having acidic pH.

In another embodiment of the present invention, there is provided apharmaceutical composition comprising vasopressin or apharmaceutically-acceptable salt thereof, wherein the pharmaceuticalcomposition is free of acetate buffer.

In another embodiment of the present invention, the composition of thepresent invention has a pH in the range of 2.4 to 3.6. Preferably, thecomposition has a pH in the range of 2.8 to 3.2.

In another embodiment of the present invention, the composition of thepresent invention has glycine as a buffering agent and has a pH in therange of 2.8 to 3.2.

In another embodiment of the present invention, the composition of thepresent invention has sodium acetate as a buffering agent.

In another embodiment of the present invention, the composition of thepresent invention has aspartic acid as a buffering agent.

In another embodiment, the suitable pH adjusting agent includehydrochloric acid, sodium hydroxide, and succinic acid.

In another embodiment, suitable vehicles are selected from the groupcomprising water for injection, ethanol, glycerin, propylene glycol,corn oil, peanut oil, and cotton seed oil.

In another embodiment, suitable tonicity agents include dextrose,glycerol, sodium chloride, potassium chloride, glycerine, and mannitol.

In another embodiment, suitable preservative is selected from benzylalcohol, parabens (methyl, propyl, butyl), benzalkonium chloride,chlorobutanol, and thiomersal.

In another embodiment, suitable lyoprotectants include sucrose,trehalose, mannitol, glycine, lysine and dextran.

In another embodiment, suitable bulking agents include sucrose, lactose,trehalose, mannitol, sorbitol, glucose, PVP, and hydroxyethyl starch.

In a preferred embodiment of the present invention, the pharmaceuticalcomposition comprises of about 0.01 mg/mL to about 0.07 mg/mL ofvasopressin, about 0.01 mg/ml to about 20 mg/ml of glycine buffer, waterfor injection and the said composition is adjusted with 0.1 N HCl orsodium hydroxide to pH of about 2.8 to 3.2.

In one another embodiment, the present invention provides a stablepharmaceutical composition comprising vasopressin or apharmaceutically-acceptable salt thereof and one or morepharmaceutically acceptable excipients, wherein the pharmaceuticalcomposition is in the form of ready to use composition.

In one another embodiment, the present invention provides apharmaceutical composition comprising vasopressin or apharmaceutically-acceptable salt thereof and pharmaceutically acceptableexcipients, wherein the pharmaceutical composition is in the form ofaqueous solution or a lyophilized powder, which can be diluted orreconstituted just prior to use.

In one another embodiment, the present invention further provides astable pharmaceutical composition comprising vasopressin or apharmaceutically-acceptable salt thereof and one or morepharmaceutically acceptable excipients, wherein the composition hastotal impurities less than 10% upon storage at 2 to 8° C., preferablyless than 5%.

The pharmaceutical compositions as per the present invention can besterilized using any of the known methods of sterilization, such asfiltration, moist heat, dry heat, gas sterilization or irradiation(gamma and electron beam), preferably by filtration. The container inwhich composition is filled can be sterilized using gamma irradiation orethylene oxide or pre-acetic acid or any other conventional method ofsterilization.

The present invention is further illustrated by the following exampleswhich are provided merely to be exemplary of the invention and don'tlimit the scope of the invention. Certain modifications and equivalentswill be apparent to those skilled in the art and are intended to beincluded within the scope of the present invention.

Example 1

Quantity Ingredient mg/mL % w/v Vasopressin 20 IU equivalent to 0.0450.0045 Glycine 0.45 0.045 Hydrochloric Acid/ q.s. to pH range q.s. to pHrange Sodium hydroxide 2.4 to 3.6 2.4 to 3.6 Water for Injection q.s.q.s.

Process:

-   -   1. Collecting 80% of water for injection and cooling it to room        temperature (20-25° C.).    -   2. Adding glycine in above collected water, and keep stirring        till clear solution is formed.    -   3. Adjusting the pH with hydrochloric acid or sodium hydroxide        in the range of 2.4 to 3.6.    -   4. Adding Vasopressin in step 3 solution and keep stirring till        clear solution is formed.    -   5. Making up the volume to 100% batch size.    -   6. Filtering the solution and then filling in a glass vial.    -   7. Storing the solution at 2-8° C.

Quantity Ingredient mg/mL % w/v Vasopressin 20 IU equivalent to 0.0450.0045 Glycine 0.90 0.090 Hydrochloric Acid/ q.s. to pH range q.s. to pHrange Sodium hydroxide 2.8 to 3.2 2.8 to 3.2 Water for Injection q.s.q.s.

Example 2 Process:

-   -   1. Collecting 80% of water for injection and cooling it to room        temperature (20-25° C.).    -   2. Adding glycine in above collected water, and keep stirring        till clear solution is formed.    -   3. Adjusting the pH with hydrochloric acid or sodium hydroxide        in the range of 2.8 to 3.2.    -   4. Adding Vasopressin in step 3 solution and keep stirring till        clear solution is formed.    -   5. Making up the volume to 100% batch size.    -   6. Filtering the solution and then filling in a glass vial.    -   7. Storing the solution at 2-8° C.

Example 3

Quantity Ingredient mg/mL % w/v Vasopressin 20 IU equivalent to 0.0450.0045 Glycine 12.0 1.20 Hydrochloric Acid/ q.s. to pH range q.s. to pHrange Sodium hydroxide 2.8 to 3.2 2.8 to 3.2 Water for Injection q.s.q.s.

Process:

-   -   1. Take approx 80% of batch size quantity of Water for        injection.    -   2. Add Glycine in it and stir for 20 minutes till clear solution        formed. Check the pH of bulk solution.    -   3. Adjust the pH of solution with 0.1N hydrochloric acid or        sodium hydroxide to 2.8 to 3.2.    -   4. Add the required quantity of vasopressin API in step 3        solution and continue stirring for 15 min or till clear solution        formed.    -   5. Volume make up to 100% of batch size with remaining quantity        of water for injection.    -   6. Check the final pH of bulk solution.    -   7. Filter the solution through 0.22p sterilizing grade filter.    -   8. Fill the solution in USP-Type-I clear glass vial and seal        with 13 mm rubber stopper.

Example 4

Quantity Ingredient mg/mL % w/v Vasopressin 20 IU equivalent to 0.0450.0045 Sodium acetate trihydrate 1.36 0.136 Hydrochloric Acid/ q.s. topH range q.s. to pH range Sodium hydroxide 2.8 to 3.2 2.8 to 3.2 Waterfor Injection q.s. q.s.

Process:

-   -   1. Take approx 80% of batch size quantity of Water for        injection.    -   2. Add sodium acetate in it and stir for 20 minutes till clear        solution formed. Check the pH of bulk solution.    -   3. Adjust the pH of solution with 0.1N hydrochloric acid or        sodium hydroxide to 2.8 to 3.2.    -   4. Add the required quantity of vasopressin API in step 3        solution and continue stirring for 15 min or till clear solution        formed. Check the pH of solution.    -   5. Volume make up to 100% of batch size with remaining quantity        of water for injection.    -   6. Check the final pH of bulk solution and maintain the final pH        in the range of 2.8 to 3.2.    -   7. Filter the solution through 0.22p sterilizing grade filter.    -   8. Fill the solution in USP-Type-I clear glass vial and seal        with 13 mm rubber stopper.

Example 5

Quantity Ingredient mg/mL % w/v Vasopressin 20 IU equivalent to 0.0450.0045 Acetic acid q.s. q.s. Sodium hydroxide q.s. to pH range q.s. topH range 2.8 to 3.2 2.8 to 3.2 Water for Injection q.s. q.s.

Process:

-   -   1. Take approx 80% of batch size quantity of Water for        injection.    -   2. Add acetic acid in it and stir for 20 minutes till clear        solution formed. Check the pH of bulk solution.    -   3. Adjust the pH of solution with sodium hydroxide in the range        of 2.8 to 3.2.    -   4. Add the required quantity of vasopressin API in step 3        solution and continue stirring for 15 min or till clear solution        formed. Check the pH of solution.    -   5. Volume make up to 100% of batch size with remaining quantity        of water for injection.    -   6. Check the final pH of bulk solution and maintain the final pH        in the range of 2.8 to 3.2.    -   7. Filter the solution and filled into glass vial.

Example 6

Quantity Ingredient mg/mL % w/v Vasopressin 20 IU equivalent to 0.0450.0045 Aspartic acid 0.30 0.03 Sodium hydroxide q.s. to pH range q.s. topH range 2.8 to 3.2 2.8 to 3.2 Water for Injection q.s. q.s.

Process:

-   -   1. Take approx 80% of batch size quantity of Water for        injection.    -   2. Add aspartic acid in it and stir for 20 minutes till clear        solution formed.    -   3. Adjust the pH of solution with sodium hydroxide in the range        of 2.8 to 3.2.    -   4. Add the required quantity of vasopressin API in step 3        solution and continue stirring for 15 min or till clear solution        formed.    -   5. Volume make up to 100% of batch size with remaining quantity        of water for injection.    -   6. Check the final pH of bulk solution and maintain the final pH        in the range of 2.8 to 3.2.    -   7. Filter the solution and filled into glass vial.

Stability Studies:

The pharmaceutical compositions of the present invention as preparedaccording to examples 3 and 4 were tested for stability for 3 months at2 to 8° C. The results of the same are provided in table 1 below.

TABLE 1 Vasotrict ® End of Example 3 Example 4 Shelf 2-8° C. 2-8° C.Test Parameters Specification Initial life Initial 3 M Initial 3 M Assay 90% to 110% 103.5   103.1   102.4   99.10  102.70  99.01  pH 2.5 to 4.53.90 Not 2.80 2.90 2.80 2.90 done Des Pro NMT 1.0% ND ND 0.15 0.09 0.140.10 Vasopressin 8 Orn NMT 1.0% 0.09 0.37 0.42 0.24 0.33 0.31Vasopressin Endo gln NMT 1.0% 0.29 0.22 ND ND ND ND VasopressinVasopressin BIS- NMT 1.0% ND ND ND ND ND ND SH Vasopressin Acid NMT 1.0%0.30 0.36 0.06 0.28 0.08 0.35 5-Asp NMT 1.0% 0.08 0.08 ND 0.1  ND 0.07Vasopressin 4-Glu NMT 1.0% 0.22 0.37 0.12 0.37 0.27 0.43 VasopressinVasopressin NMT 1.0% ND ND ND ND ND ND Parallel Dimer Vasopressin NMT1.0% ND ND ND ND ND  0.004 Antiparallel Dimer N-Acetyl NMT 1.0% 0.210.21 0.08 0.08 0.07 0.07 Vasopressin Total Impurities NMT 10% 1.36 1.741.09 1.53 1.45 1.96

Results:

The vasopressin content was measured to be in range of 99.1 to 99.0 forcompositions of example 3 and 4 respectively, which is in acceptablelimits range (Limit 90.0-110.0%). Total impurities were measured to be1.53% and 1.96% for compositions of examples 3 and 4 respectively whichare also within the acceptable limit of NMT 10%.

Hence, it is concluded from the above stability data that thecompositions prepared as per the present invention have an unexpectedenhanced stability.

We claim:
 1. A stable pharmaceutical composition comprising vasopressinor a pharmaceutically acceptable salt thereof, 0.025% w/v to 1.25% w/vof a buffering agent, and one or more pharmaceutically acceptableexcipients, wherein the pharmaceutical composition is for parenteraladministration and is having a pH in the range of 2.8 to less than 3.4.2. The stable pharmaceutical composition as claimed in claim 1, whereinthe one or more pharmaceutically acceptable excipients are selected fromtonicity agents, pH adjusting agents, preservatives, vehicles, bulkingagents, lyoprotectants, or combinations thereof.
 3. The stablepharmaceutical composition as claimed in claim 1, wherein the bufferingagent is selected from citrate, phosphate, tris HCl, acetic acid, sodiumacetate, glycine, aspartic acid, histidine, cysteine, tyrosine,phenylalanine, proline, arginine, threonine, serine, valine, isoleucine,lysine, glutamine, or combinations thereof.
 4. The stable pharmaceuticalcomposition as claimed in claim 3, wherein the buffering agent isglycine.
 5. The stable pharmaceutical composition as claimed in claim 3,wherein the buffering agent is sodium acetate.
 6. The stablepharmaceutical composition as claimed in claim 3, wherein the bufferingagent is aspartic acid.
 7. The stable pharmaceutical composition asclaimed in claim 1, wherein the composition has less than 5% of totalimpurities upon storage at 2 to 8° C.
 8. The stable pharmaceuticalcomposition as claimed in claim 1, wherein the composition is diluted orreconstituted just prior to use.
 9. The stable pharmaceuticalcomposition as claimed in claim 1, wherein the composition is in theform of ready to use composition.
 10. The stable pharmaceuticalcomposition as claimed in claim 1, wherein the composition is useful forincreasing blood pressure in adults with vasodilatory shock.
 11. Thestable pharmaceutical composition as claimed in claim 1, wherein thecomposition is filled into a single dose vial or multiple dose vial. 12.The stable pharmaceutical composition as claimed in claim 9, wherein thecomposition is free of preservative.